Why Doctors Are Freaking Out About the JUUL, the Latest E-Cigarette Trend

Because the JUUL is relatively small and discreet, parents and teachers are concerned about teenagers surreptitiously using the JUUL during class

There is evidence to suggest that e-cigarettes in general come with serious health risks

According to a 2018 release from the Food and Drug Administration (FDA), the teen vaping trend has reached “epidemic proportions” and the agency plans to crack down on retailers who sell to teens

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Remember when you were a teenager and you’d lurk in shadowy alleyways or a friend’s basement to sneak an occasional cigarette, safe from the prying eyes of adults? Well, thanks to the rise of the e-cigarette, those days are over. With vapes, people can catch a smoke anytime, anywhere — even in class. And that’s especially true with the JUUL, an e-cigarette popular among high school and college students that has parents and teachers incredibly concerned.

It also has the government concerned, according to a new press release from the FDA. In the report, commissioner Scott Gottlieb vowed to crack down on the “epidemic” of teen vaping and penalize retailers who sell e-cigarettes to minors.

“While we remain committed to advancing policies that promote the potential of e-cigarettes to help adult smokers move away from combustible cigarettes, that work can’t come at the expense of kids,” Gottlieb said. “We cannot allow a whole new generation to become addicted to nicotine.” The press release also cited the JUUL specifically, adding that earlier this year, the FDA issued more than 60 warning letters and fines to retailers that sold JUUL brand products to minors.

But what exactly is the JUUL, and what are the risks associated with vaping in general? Here’s what we know.

What Is a JUUL?

Getty ImagesThe Washington Post

The JUUL is a compact, USB-shaped vaping device. In most respects, it isn’t much different from most other e-cigarettes, says cardiologist Holly Middlekauff, M.D., professor of medicine and physiology at the David Geffen School of Medicine at UCLA.

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“The liquid is pretty much the same. It has solvents, nicotine, and flavorings,” Middlekauff told MensHealth.com. The solvents help deliver the nicotine and flavors in the form of tiny particles into the lungs.

Unlike other e-cigarettes, however, the JUUL is compact and rechargeable; plus, it comes with an internal temperature-regulating mechanism that prevents it from overheating or even exploding (which has occurred with other types of vapes).

The JUUL has generated something of a cult following on social media: at the time of this writing, there are more than 82,000 posts under the #JUUL hashtag on Instagram. But as trendy as it is, the device still contains nicotine and is a major health concern, say medical experts.

Why are people freaking out about the JUUL?

On its website, JUUL says that the device is intended for people 21 and up. But parents and educators are reporting that kids are using the devices in the classroom.

One 16-year-old high school student from California recently told CNN that students get away with puffing Juuls in class, dipping into their backpacks for a quick hit when the teacher’s head is turned and then tucking the tiny device away before they turn back.

“A parent may not recognize it as anything other than a flash drive.”

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JUULs also plug right into a computer flash drive port to charge and heat, so many people may not realize it’s a vaping device. One school district has banned flash drives to simplify matters and reduce confusion, according to a Fox News report.

“They don’t look like cigarettes. They’re a cool electronic device. And in fact, a parent may not recognize it as anything other than a flash drive,” Middlekauff says.

In a statement to MensHealth.com, a spokesperson for JUUL Labs, the maker of the JUUL device, said, “We strongly condemn the use of our product by minors, and it is in fact illegal to sell our product to minors. No minor should be in possession of a JUUL product. Our goal is to further reduce the number of minors who possess or use tobacco products, including vapor products, and to find ways to keep young people from ever trying these products.”

The JUUL also comes in a wide range of flavors such as mango, fruit medley, and creme brulee. In a 2017 letter to the Food and Drug Administration (FDA), U.S. Sen. Chuck Schumer criticized the company for promoting “flavors that are attractive to young people.”

A spokesperson for JUUL Labs denied that the brand tries to appeal to young consumers. “Flavors are an important factor in getting adult smokers to switch. We are focused on meeting the preferences and needs of adult smokers interested in finding an alternative to cigarettes,” the spokesperson told MensHealth.com.

“I’d strongly advise that you do not pick up JUULs, because they are not harmless.”

According to the JUUL website, one JUUL pod is equivalent to about one pack of cigarettes or 200 puffs — more than what’s in the typical e-cigarette, says Catherine Shoff, M.D., a specialist in pulmonary medicine at Geisinger Medical Center in Danville, Pa.

Long-term use of the JUUL may also have lasting effects on heart health. “As a cardiologist, I’m worried about someone who uses nicotine for a long time. Nicotine increases adrenaline levels. Sustained adrenaline levels increase the risk for a heart attack,” Middlekauff says.

Is the JUUL safer than traditional cigarettes?

If you do not smoke tobacco cigarettes, you should probably stay away from JUULs and other e-cigarettes, says Middlekauff. “I’d strongly advise that you do not pick up e-cigarettes, including JUULs, because they are not harmless,” she says.

But if you are already a tobacco smoker, switching to a JUUL is probably safer than smoking a traditional cigarette, she adds. There is evidence to suggest that substituting e-cigarettes for conventional cigarettes reduces users’ exposure to toxicants and carcinogens present in conventional cigarettes, but more research is needed to actually prove that this is true.

Shoff says she is also concerned that the JUUL could potentially serve as a gateway drug to traditional tobacco cigarettes, though more research is needed to support that as well.

“For a first-time nicotine user, JUULs are a slippery slope,” she says.